Use of consecutive transcutaneous oxygen measurement when assessing the need for revascularization and association with the outcomes of ischemic diabetic ulcers

在评估是否需要血管重建时使用连续经皮氧测量及其与缺血性糖尿病溃疡预后的相关性

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Abstract

This study compared the ankle-brachial index (ABI) with transcutaneous oxygen pressure (TcPO(2) ) in assessing peripheral vascular disease (PVD) prevalence in 100 diabetic foot ulcer (DFU) patients. Patients were categorized into vascular or nonvascular reconstruction groups and underwent both ABI and TcPO(2) measurements four times over 6 months. Predictive validity for PVD diagnosis was analysed using the area under the receiver-operating characteristic curve (AUC). The study found TcPO(2) to be a superior predictor of PVD than ABI. Among the DFU patients, 51 with abnormal TcPO(2) values underwent vascular reconstruction. Only TcPO(2) values showed significant pretreatment differences between the groups and increased post-reconstruction. These values declined over a 6-month follow-up, whereas ABI values rose. For those with end-stage renal disease (ESRD), TcPO(2) values saw a sharp decrease within 3 months. Pre-reconstruction TcPO(2) was notably lower in amputation patients versus limb salvage surgery patients. In conclusion, TcPO(2) is more effective than ABI for evaluating ischemic limb perfusion and revascularization necessity. It should be prioritized as the primary follow-up tool, especially for ESRD patients.

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